Nepal’s National Health Policy 2019: A Critical Review

Nepal’s health policy landscape has evolved significantly over the past decades, transitioning from curative-focused and centralized approaches toward preventive, equitable, and decentralized health governance. Beginning with the first National Health Policy of 1991, successive reforms in 1997, 2014, and 2019 have progressively aimed to expand access, strengthen institutional capacity, and align with global health commitments such as the Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC).This review critically examines the National Health Policy 2019 (NHP 2019) through document analysis, comparative policy review, and evaluation using the World Health Organization’s (WHO) health system building blocks framework. The findings reveal that NHP 2019 marks a major policy advancement by integrating federal governance structures, promoting health insurance and digital health systems, and recognizing emerging challenges such as non-communicable diseases, mental health, and environmental health risks.However, critical gaps persist in implementation, including weak coordination among federal, provincial, and local governments; inequitable financing and workforce distribution; insufficient data systems; and limited inclusion of marginalized populations and traditional health practices.The review concludes that while NHP 2019 is ambitious and forward-looking, its success depends on effective implementation, sustained financing, and evidence-driven governance. Strengthening intergovernmental coordination, promoting equitable resource allocation, enhancing workforce capacity, and integrating traditional medicine and community health systems are key to realizing the policy’s vision of “healthy, alert, and conscious citizens oriented to a happy life.”